Action Collaborative on Traumatic Brain Injury Care: Adapted Clinical Practice Guideline




Silverberg, Noah D.; Lee, Kathy; Mikolić, Ana; Bayley, Mark T.; Brody, David L.; Ely, E. Wesley; Giacino, Joseph T.; Halabi, Cathra; Hammond, Flora M.; Ignacio, Daniel A.; Mosti, Caterina; van der Naalt, Joukje; Pappadis, Monique R.; Ravi, Anita; Tenovuo, Olli; Wang, Vincent Y.; Verduzco-Gutierrez, Monica; Manley, Geoffrey T.; On behalf of the Action Collaborative on TBI Care

PublisherMary Ann Liebert Inc.

2025

 Journal of Neurotrauma

08977151251378894

0897-7151

1557-9042

DOIhttps://doi.org/10.1177/08977151251378894

https://doi.org/10.1177/08977151251378894



Outpatient follow-up care for traumatic brain injury (TBI) is inconsistent. The Action Collaborative on TBI Care, convened under the auspices of the National Academies of Sciences, Engineering, and Medicine, aimed to standardize management with a clinical practice guideline. The guideline is intended for community-dwelling adults with TBI who are able to care for themselves at hospital discharge or who did not require acute hospital care. Guideline topics were selected and prioritized with input from individuals with lived experience and clinicians. Existing evidence-based clinical practice guidelines (k = 18) were identified from systematic literature reviews. Recommendations for each priority topic were extracted from existing guidelines and synthesized using the ADAPTE process. Strength of evidence ratings were assigned based on the American Academy of Family Physician's adaptation of GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) through consensus voting. A draft guideline underwent external review by 20 health professional and brain injury organizations. The Action Collaborative on TBI Care guideline provides recommendations for 11 priority topics: (1) confirm the diagnosis; (2) determine whether emergency department evaluation is required; (3) request neuroimaging and neuropsychological assessment when indicated; (4) screen for social determinants of health; (5) provide guidance on return to usual activities; (6) educate the patient and family; (7) assess for risk of persistent symptoms; (8) prioritize which symptoms to target first; (9) initiate treatment for posttraumatic headache; (10) screen and initiate treatment for mental health disorders; and (11) decide if and when to refer to specialty care.



The Forum on TBI is supported by the National Academies of Sciences, Engineering, and Medicine. The Action Collaborative on TBI Care is funded by generous donations from an anonymous donor, the Weill Family Foundation, and the Maurice Marciano Family Foundation to the University of California San Francisco (UCSF). The donors were not involved in the guideline development process.


Last updated on 05/11/2025 03:50:13 PM